Bad Decision

The Obama administration has rejected appeals to exempt religious-affiliated institutions, such as hospitals and universities, from the mandate issued by the Department of Health and Human Services requiring all health-insurance policies to include free coverage for contraceptives and other “preventive” services such as sterilization.

This was a serious mistake (see “An Illiberal Mandate,” December 20, 2011). The administration’s decision raises deep concerns about its understanding of the fundamental corporate and institutional nature of the Catholic Church and similar religious communities. The HHS decision comes perilously close to insisting that the government should determine what is or isn’t a religious organization or ministry. The reasoning behind restricting the exemption to institutions that primarily employ and serve coreligionists appears to be based on an essentially sectarian, and historically Protestant, understanding of “religion.” The Catholic Church, which understands its public presence to be vital to its identity and mission, should not be forced to abide by such restrictions.

Recognizing how potentially disruptive the decision is, the administration gave institutions an extra year to comply. Many hope that a compromise can still be reached. One possible solution would be to segregate funds the way the Affordable Care Act segregates funding for abortion. Employees seeking coverage for contraception would have to purchase that separately, but without incurring a financial burden. That administrative solution has worked to the satisfaction of Catholic institutions in Hawaii, where a state law mandates contraception coverage.

The hyperbolic response of the bishops is not likely to help fix things. “Let us make no mistake: the future of our freedoms in our beloved republic is threatened now as never before,” said Bishop William Lori, chair of the USCCB’s Ad Hoc Committee on Religious Liberty. Bishops now face the choice of either violating their consciences or dropping health coverage for employees, Lori claims. But providing policies that allow individuals the option of using contraceptives does not involve any direct cooperation with evil on the part of the church. No Catholic physician is being forced to prescribe contraception or to perform sterilizations; no Catholic hospital is being forced to dispense contraception or permit sterilization procedures. If Catholic institutions must choose between complying with the law or dropping health-insurance coverage for employees, they should comply “under duress,” while working to modify or overturn the law. In this instance, the greater good of providing health insurance for all employees outweighs the “evil” involved in the possible use of contraception by some. A different calculus would be employed if the funding in question were for elective abortion, which is a much graver evil.

The bishops are right to oppose this mandate vigorously, but reversing the decision will depend in part on adopting a more measured tone—not lending credence to attacks suggesting the administration is motivated by anti-Catholic or anti-religious bias—and acknowledging that this is a legitimate health issue on which people of good will can differ. It is hard to ignore the fact that this is an election year, and that the presidential candidates of one party are rallying against a so-called war on religion. In this context, the bishops must not underestimate the dangers of partisan entanglement. For good and bad reasons, many bishops are deeply suspicious of the Obama administration. It would be a serious mistake, however, to let those suspicions create the impression that the church is allying itself with one party. As many religious champions of liberal causes associated with the Democratic Party discovered in the 1960s and ’70s, such entanglements usually discredit one’s cause, undermine the church’s teaching authority in general, and drive away significant segments of the faithful. If the bishops don’t want their concerns exploited for partisan uses, they have to make that point dramatically clear. So far they have failed to do so.

Nor should the bishops underestimate the potential this issue has for further dividing Catholics. In opposing the extension of access to contraception to tens of thousands of women, the church has once again maneuvered itself into a position where it will widely be seen—by Catholics and non-Catholics alike—as an institution in which celibate old men lay down the rules for how women should conduct themselves in the most intimate realm of their lives. Whether the bishops like it or not, the mandate is not only a religious-freedom issue; it is also a women’s issue. If the church cannot demonstrate that it understands the unique health needs and concerns of those most directly affected by the HHS ruling, it will lose the larger cultural and political argument while further alienating many within its own house.

Comments

Excellent editorial. I am sure, too, that the "mandate" will be a dead issue in a month or sooner (if only to avoid making it a single-issue matter [among Catholic, Jewish Orthodox, evangelical Democrats] in the upcoming November election). The Obama Administration will come up with a third option or some kind of compromise. What a pity the president's advisors didn't advise him differently and earlier to avoid making so many undutiful, unfaithful Democrats. Even Chris Matthews is against the mandate! Wow!

I see the Obama Administration as trying to balance the First Amendment's dictum of not "prohibiting the free exercise" of religion with the demands of the constitutionally protected right to privacy and the Fourteenth Amendment's requirement that all citizens enjoy "equal protection of the laws."

In this case, those citizens are women who just happen to be employed in a Catholic hospital or university or service agency. Catholic "ministers" [i.e., priests, parish and diocesan workers] are exempted from the ACA Act.

What is wrong with that compromise? This arrangement the President is offering under the ACA Act is similar to ones that have been operative in 28 states for years. What has changed that so unnerves the hierarchs?

Besides, by standing firm President Obama has contributed to further reducing the need for abortions, therefore abortion itself, by insisting on reliable birth control services to all women- something that the hierarchs are incapable or unwilling to endorse.

You'd think that reducing abortions would be viewed by the hierarchs as the morally "greater good" especially since they lost the contraceptive argument with especially Catholic women decades ago. [And, Catholic women are not going back to pre-contraceptive days!]

I'm disappointed, if not dismayed, to have so much emotion invested in an issue which is mostly theoretical and entirely esoteric, while ignoring the consideration of something which is entirely real, which is 1.2 million abortions per year.

What is theoretical and esoteric is how money is collected and distributed, under insurance contracts. The issue is forcing Church-administered businesses, providing highly secular services, and employing large numbers of non-believers (both non-Catholics and Catholics) to buy insurance policies which cover contraceptive services for those individuals who wish to receive them.

All of us are forced to pay for things in which we don't believe and which contravene our religions and personal moralities. I'm against capital punishment (so is the Church) and I was against the Iraq War; yet I was forced against my will and conscience to pay for both.

I don't accept that the personal moralities of the board of directors of a hospital or college is of greater consequence than my personal morality or the personal morality of anyone else, when it comes to distribution of tax dollars. A businessman who is a Jehovah's Witness would be required to offer health insurance policies which covered blood transfusions, in contravention of that person's religious teachings.

It really is a slippery slope, when it comes to claiming religious freedom -- not at the level of the individual or at the level of a true, clearly religious entity (church, church school, mission, etc.) -- but at the level of the Board of Directors of a large business, engaged in primarily secular activities.

It's been pointed out that (1) Catholic-affiliated institutions already have to live with such insurance mandates at the state level and (2) Catholic-affiliated institutions already do subsidize contraceptive services through paying money to insurance companies which offer contraceptive services to other employers, thus subsidizing these latter policies through the profits which the Catholic institutions provide to these insurance companies.

When you actually start tracking the flow of dollars ("follow the money"), things really do become theoretical and esoteric.

For all the heated political and religious rhetoric against abortion, the single greatest thing which has saved the most babies from being killed by abortionists is contraception. After Roe v Wade, abortions went way up. Everyone knows that. What people don't know so much is that, since 1985, abortions have gone way down. A decline of something like 380,000 per year, since then:

This coincides with an explosion of contraceptive services and with the increasing availability of better contraceptives. Adjusted for population, the number of abortions is descending to the level existing before Roe v Wade.

Half of all pregnancies are unplanned. Of the unplanned pregnancies, 40% end up with abortion (baby killing). A lot of unplanned pregnancies occur because of ineffective use of contraceptives. This is why it's not only important to pay fo the contraceptives, but also to pay for counselling (part of proposed HHS regulations) on effective use of conraceptives.

If the HHS regulations go into effect and ObamaCare is not repealed by the GOP, the number of babies killed per year will drop dramatically, to well below the levels existing before Roe v Wade. So while the social conservatives rant and rage against Roe v Wade, without accomplishing anything, supporters of contraception have been quietly preventing the slaughter of 380,000 babies per year and this "liberal" Democratic admininstration will prevent the slaughter of an additional half million per year, over time.

I discussed on another thread how Pope Paul VI's Humanae Vitae states that lesser evils may legitimately be carried out to prevent greater evils. Contraception is a violation of natural law. Abortion is a violation of the 5th Commandment.

But the Catholic Bishops are more concerned about "following the money" in an esoteric economic sense, than in actually doing something effective, in terms of going after the true evil elephant in the room.

P.S., regarding my previous comment (I wish that there were an "edit" button - alas). Anyway, I'd like to change some wording, in anticipation of a predictable objection):

I don't accept that the personal moralities of the board of directors of a hospital or college is of greater consequence than my personal morality or the personal morality of anyone else, when it comes to distribution of tax dollars government-mandated personal or corporate expenditures.

“Hyperbolic response of the bishops”?First, government intrusions that have forced Catholic Charities out of providing adoption services in Massachusetts and Washington, D.C. and now this and during an election year to boot!!.I can’t imagine what will he do, if reelected?Obama is a secularist tyrant who rails against the restrictions that the constitution places on his ability to “fundamentally transform this country.” Your biggest complaint seems to be that he may have awakened a giant and you would prefer that we all supinely accept dictates from the new “Messiah.”

So does the health insurance provided by the Catholic church not cover costs related to hysterectomies, tubal ligations & vasectomies? Must the patient first prove it is "medicinal" before it is authorized? (hhmm...the phrase "death panel" comes to mind). If the Catholic employer provides Medical Flex spending accounts for its employees, do they make sure the account won't reimburse for condoms or co-pays on other contraceptives? I guess if the Catholic church refuses to have the insurance and flex spending accounts they provide pay for any and all male and female contraceptives possible through every available means, I'd have less of a problem with this. But to take it out on just women is discrimination and flat out unfair.

Earlier today, the President announced an accommodation to religious affiliated institutions: the new plan requires the insurer, not the religious institution, to offer contraception coverage at no cost to the insured.While the accommodation should quell much of the uproar, the bishops are withholding judgment.

I generally find Commonweal’s editorials on point and while I applaud the tone of this one, I do not agree that the administration’s earlier regulation represented a threat to “religious liberty.”As an earlier writer noted, more than 25 states already require insurers who cover prescription drugs to cover the full range of FDA-approved contraceptive prescriptions.Eight of those states do not provide the “church” exclusion provided in the administration’s regulation.Additionally, many Catholic universities and hospitals have been providing coverage for contraception in their health plans for years, among them: Georgetown, Fordham, Marquette, and DePaul.Finally, the insurer for the archdiocese of New York began providing access to contraception in 2002 even before they would have been required to so do under state law.

The politically charged environment manufactured by the bishops’ “outrage” and stoked by opportunistic republicans (as well as some democrats) is dishonest at best.

You have to hand it to our president.He was able to get insurance companies to provide contraceptive services for nothing.When was the last time an insurance company provided coverage for nothing?But wait, the woman can’t just get the coverage from any insurance carrier; she has to go to the health insurer used by her employer, who pays the insurance premium that undoubtedly includes the cost of this “free” coverage.In short, the religious institution will be paying for contraceptive services.Where’s the compromise?This is really an insult to our intelligence, and we need to replace this tyrant in the next election.

It may have been a bad decision. But it was also a case of bishops behaving badly. Hardly good shephards, using their staffs gently to guide any strays back into the fold. Hardly what Jesus would do. He asked others to follow him. He didn't command people to obey him. He led by example. And only twice was he reported to show anger: at the money changers in the temple (which should show how he might react to our greed-is-good culture) and at the barren fig tree. He also avoided politics: "Render to Caesar what is Caesar's and to God what is God's" The bishops were too primed to react, apparently by a page from the Republican political playbook, to heed Christ's wise warning about mixing faith and politics.

The administration should have negotiated and discussed first rather than issue the mandate with its one year negotiation/discussion period. The bishops should have talked with the President privately first rather than unleash their barrage that included one bishop telling him in public (and not face to face) to go to hell.

When Obamacare comes fully online, nearly every woman in the U.S. will have insurance that covers contraceptives, except those who work at religious-affiliated organizations. That will severely limit the ability of those organizations to recruit workers from among the substantial segment of the population whose religious beliefs do not preclude contraceptive use. When that happens, religious-affiliated organizations will not be able to provide the highest quality staff or services.

What pregnant women would utilize a Catholic hospital that would refuse to treat a possible life-threatening ectopic pregnancy and that can't provide the highest-quality staff?

Where religious faith compels institutions to take action in the secular world, they have an obligation to provide the highest possible quality of service to the community. Failing to do so can only call into question the underlying motivations of their efforts.

As I understand the Bishop's argument, contraception is such a grave sin that any institution that cooperates in its use, even by non-Catholics, shares in the grave error. They extend this reasoning even to the provision of comprehensive empolyee health insurance. In my view, there are several glaring problems with this position. First, many Catholic institutions ALREADY provide such coverage, some as required by local State law, and others purely voluntarily. Are these institutions going to be required to end the practice? If the argument is that it is voluntary and they should not be compelled by the government, that's a good legal argument, but not a moral one.

Perhaps worse, some of the very Catholic institutions involved in the controversy are themselves profiting from the manufacture, distribution and sales of contraceptives through their endowment and other investments...or do they avoid investing in Pharma, transportation companies and retail stores? I doubt it. And the de minimus argument of the diversity and breadth of their investments doesn't hold up under the comparison to insurance coverage for a minimal cost service.

So, on balance, it really seems more like a partisan political statement than one based on conscience, reason and moral thought.